The president's health care initiative is vulnerable to defeat (and the high esteem in which the public generally has held him is in jeopardy) because of unforced errors on his part deriving from the emerging legislation's failing to carry out his stated policy and because of his political and policy responses to that problem.
His policy has been that:
--We have an obligation to provide health care for virtually all American citizens without increasing the deficit.
--To gain economic recovery, we must, this year, pass health legislation that eventually would bring down health care costs.
--Voters with incomes of less than $250,000 will not have their taxes raised.
However, the Congressional Budget Office has found that the legislation would not cover virtually all of the uninsured; it would increase the deficit by more than $1 trillion; it would increase in the long term, rather than reduce, the overall cost of health care; and the president has proposed more than $9 trillion in new deficits so far overall.
The strategic contradictions between the president's vision and the emerging legislative reality are turning his own visionary words against the rationale for his actual legislation -- particularly among those who supported his vision. This is draining positive political energy from his base supporters.
Moreover, the public's fear of unprecedented deficits now exceeds its desire for general health care reform; a majority of the public now fears that the president's specific health care legislation may reduce the quality of their care; and about 8 in 10 voters are satisfied with the health care insurance they have. Thus, among his soft supporters, independents and soft opposition, support for his health initiative is either softening or turning into opposition.
Ominously, according to the daily Gallup tracking poll of presidential job approval, not only was the public lowering its regard for the president's health policy but also, as the president was sent out every day by his staff to personally make health care arguments with which only about 40 percent of the public agreed, these attitudes started branding the president personally, and his overall job approval level slid almost a point a day for several days.
As the White House was gripped by the foregoing developments, officials began to change their objectives and methods. Thus, in a rare -- and ill-considered -- public speech, the president's pollster, Joel Benenson, told the Economic Club of Canada that polling revealed that although elements of the health care reform plan aren't too popular, people "think the insurance companies have been the villains here, not the government."
So a week ago, the White House and its Democratic Party allies recalibrated their rhetoric away from the old, positive presidential vision and started targeting the insurance industry. In North Carolina, the president told an audience that the existing system "works well for the insurance industry, but it doesn't always work well for you. ... What we need -- and what we will have when we pass these reforms -- are health insurance consumer protections to make sure that those who have insurance are treated fairly and insurance companies are held accountable."
The danger for the administration now is that as it shifts from the former inclusive, positive message to the new divisive, negative message, factual accuracy and rhetorical tone easily can get out of control. For example, while the president's words, quoted above, were tonally safe, House Speaker Nancy Pelosi a few days later shrieked about the private insurance companies. "They are the villains in this," she said. "They have been part of the problem in a major way."
According to the newspaper The Hill, "As (Pelosi) prepare(d) to send her members home for the month of August having not voted on a healthcare bill -- a deadline the Speaker said she would meet for President Obama -- (she) said she was urging those members to go on the attack against the private insurance industry."
Yet, again according to The Hill, the health insurance industry "has already agreed to new regulations key to the Democratic proposals (other than the public insurance provision), such as no longer denying coverage because of pre-existing conditions and no longer using health status or gender to establish insurance premiums."
Thus, as the president's allies continue to mischaracterize and demonize the insurance industry, there may be unanticipated political effects. While it is doubtlessly true that many people don't trust insurance companies, it may be politically unwise to insult an entire industry.
After all, I estimate that the insurance sector of our economy employs more than 2 million adults, who have more than a million spouses and adult, voting children. Also, there are perhaps another million retired former insurance industry employees, for a total of more than 4 million voters, about 10,000 voters per congressional district -- or about 3 percent of total votes cast per congressional district. Is it really helpful for Democratic members of Congress to demonize -- and threaten the livelihoods and honor of -- all those nice American voters?
Then last weekend, both the president's treasury secretary and his senior economic adviser, shooting at something or other with both barrels, predicted that to get the deficits they are raising back down again, the president may have to raise taxes on the middle class. Here's a thought: If Congress doesn't increase the deficit by trillions, it doesn't need to raise middle-class taxes by trillions. Going down?